MEDICARE: GRACE RECOVERY CENTER CORP.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	324500000X	Substance Abuse Rehabilitation Facility

General Provider Information

NPI Number	:	1194500793
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GRACE RECOVERY CENTER CORP.

Provider Business Mailing Address
First Line	:	1001 GALLATIN AVE
Second Line	:
City	:	NASHVILLE
State	:	TN
Zip	:	37206-3231
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1001 GALLATIN AVE
Second Line	:
City	:	NASHVILLE
State	:	TN
Zip	:	37206-3231
Country	:	US
Telephone Number	:	781-708-6479
Fax Number	:

Authorized Official
Title or Position	:	BILLING
Name	:	THOMAS RIELLY
Credential	:
Telephone Number	:	781-708-6479

Provider Enumeration Date	:	08/30/2023
Last Update Date	:	09/30/2025

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Directions to “GRACE RECOVERY CENTER CORP. ” Practice Location

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